Skip Navigation

European Heart Journal 1997 18(Supplement D):68-77; doi:10.1093/eurheartj/18.suppl_D.68
Copyright © 1997 by the European Society of Cardiology.
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Geleijnse, M. L.
Right arrow Articles by Fioretti, P. M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Geleijnse, M. L.
Right arrow Articles by Fioretti, P. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1997 The European Society of Cardiology

Should the diagnosis of coronary artery disease be based on the evaluation of myocardial function or perfusion?

M. L. Geleijnse, A. Salustri*, T. H. Marwick{dagger} and P. M. Fioretti

Thoraxcenter, University Hospital Dijkzigt and Erasmus University Rotterdam, The Netherlands
* Division of Cardiology, Sandro Pertini Hospital Roma, Italy
{dagger} Cleveland Clinic Foundation Cleveland, Ohio, U.S.A.

Correspondence: Marcel L. Geleijnse. MD, Thoraxcenter BA 302, Dr Molewaterplein 40. 3015 GD Rotterdam, The Netherlands

The aim of this review was to define the place of stress (exercise, dobutamine, and vasodilator) echocardiography in the context of perfusion scintigraphic techniques for the detection of coronary artery disease. Echocardiography and nuclear imaging have their strong and weak points. Echocardiography has the benefit of widespread availability, relatively low cost, portability, absence of radiation, safety, and determination of ischaemic threshold. However, echocardiographic imaging cannot be performed during treadmill exercise, the echocardiographic windows are variable with sometimes poor echogenicity, and interpretation is subjective and requires an important learning curve.

Diagnostic comparisons were focused on studies involving echocardiographic and nuclear imaging in the same patients. These direct comparisons show that exercise or dobutamine echocardiography and perfusion imaging have similar accuracies for the detection and localization of coronary artery disease. Perfusion imaging may be more sensitive in the detection of mild coronary artery disease; echocardiography, however, has a better specificity. Vasodilator perfusion imaging is superior to vasodilator echocardiography, although the new dipyridamole-atropine echocardiography test will make future reassessment neccesary. Once the condition of adequate echocardiographic training is fulfilled, we believe that the selection of one or other test should be tailored to clinical circumstances rather than be a uniform decision.

Key Words: Coronary artery disease • stress echocardiography • myocardial perfusion scintigraphy


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.